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HomeMy WebLinkAboutCAMPBELL HEIGHTS BLK 3 LT 20 fi unicipalitYof Anchor e 825 "L°' STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE Al. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION December 31~ 1980 John R. Lowe 8859 Browning Drive Anchorage, Alaska 99507 Permit # 800054 = Subject: Lot 20 B16ck 3 Campbell Heights Subdivision A permit issued by this department for well and/or sewer system has expired as of this date. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document, the installation date. If an engineer inspected the installation of the oP-site sewer system, please have them send us the as-butlts for our files. If there are any further questions, please call this office at 264-4720. Sincerely, sLenio; En~rh~l~ntR;~S'~cialist. LNB/ljw enc: Copy of Permit SWP/057 PERMIT NO. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 tL' STREET, ANCHORAGE, AK. 99501 264-4720 800054 ) APPLICANT JOHN R. LOWE LOCATION LEGAL ;~L20 B3 CAMPBELL HEIGHTS 8859 BROWNING DR. LOT SIZE 344-0053 14~00 SQUARE FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS i00 FEET FOR A PRIYRTE WELL OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM R PRIYRTE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS ?5 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. I CERTIFY THAT l: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND HELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED: ......................... APPLICANT JOHN R. LOWE ISSUED .................. V4. 0 PERMIT NO. hPPLICA,,n'J oN n LOCATION LEOAL t'lUN I C I PAL ! TY OF ANCH¢IRAGE DEPARTMENT ~ HEALTH AND ENVIRONMENTAL~OTECTION 825 ~L STREET~ RNCHORROE, ~K. ~4-47~ WELL - PERMIT~'OO~SJ ( TYPE OF SOIL ABSORBTION SYSTEM IS: MAXIMUM NUMBER OF BEDROOMS = SOIL RATING <SQ FT/BR>= THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= LEI'4GTH= GRFI'v'EL DEPTH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET> Of THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IH FEET>. THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET>. REQu I RED SEPT I C TANK S I ZE= GALLONS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURIMO THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE ~JMBER OF RESIDENCES THAT THE ~IELL WILL SERVE. ------ TI40 (;2 > I hlSPECT I Obis ARE REQI_I I RED BACKFILLING Of ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE NELL; OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPOH THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN.30'DAVS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERMIT EXPIRES DECEMBER 2:[~ :~ 80 I CERTIFY THAT 1: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET . FORTH BY THE MUNICIPRLITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN RCCORDRNCE WITH THE CODES. 3: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLARGEMENT IF THE SI~cR-~R~?TNT-L~-- -~REsIDENCE IS~REMO~ELED TO INCLUDE MORE ............ THAN 3.BEDROOMS. V1 2 .(~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# . O~/~- 0-/~'-OI HAA# HRqgO57 GENERAL INFORMATION : Complete'legal description ' /,.~./L ~ Location (site address or directions) ~/~ '~ 6 7~.~-~ v~'l~l~l~q ' Property owner Mailing address Lending agency Day phone 7~'.?- 5'70 Day phone Mailing address Agent Address -Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3- 3. TYPE OF WATER sUPPLY: NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ' lng to the legalityand status of system .... 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer ' If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. Be STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. DHHS SIGNATURE 7 Ap. proved for ~. Disapproved. ~ Conditional approYal for bedrooms. ,~ ~.' ~-~.~...'~. ,~_z~,~ · e [~ ... ..,. ~%~, ~rooms, with th~ following stipulations: Additional Comments Date //2 -/- ~'~' -The Municipality of An~:horage Department of Health and Human Services (DHHS) Issues Health Authority Approval Certificates based only uPon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to pumhasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate Is Issued. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. WELL DATA Health Authority Approval Checklist If A, B, or C, attach ADEC letter. ADEC water system number FROM WELL LOG g.p.m. Wires property protected (Y/N) AT INSPECTION ¥ Date of test Static water level Well productlmt g.p.m. WArir.~ SAMPLE RESULTS: Date of sample: ~ Collected by: Other bacterta ~ ~&~C/HOLDING TANK DATA ~,~ ~ Date installed ~~eanouts (Y/N) · Foundalion dean~;mt.('WR)~ Depression (Y~-'~--.~_ _High water alarm (Y/N) -- Of Pumping Pumper ~ C. ABSORPTION FIELD DATA N O~ ~ "~;l~installed _ _ Soil rating (g.p.dJfff or fF/bdrm) System type ~ Length~_ _ __ Gravel ..ess below pipe T~ Effective absotpliofl area .~...~.~.~ng Tube p~sent ~Y/N}.~_~t~&~l~over field (Y/N)- fluid dep~ ~ns) Minutes later:. Absotp~ rote .~ ~ g.p.d. ~ON ~Date i~ Size In gallons ~ Manhole/Access ~/N) ~ off' level at.  -oatum ~ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding ta~k on lot lq q ,Absorption field on lot Public sewer mai. ~ '~'"/ ~,Sewer/sep~ service line '~ ~. ~'~"'~', Public sewer manhole/cleenout,~ Lift station NDISTANCES FROM 8EPTIC/HOLDINGTANK ON LOTTO: I/~q Property line Absorption fi~ in confo~ wll~ MOA l.lAA guldeliltes irl effect on #tls da~e. ~,:~/.,?.'..' ~'~,~/,*o ~CE 9792 . ,~ ~.~.*'~'~ : - , I"IAA Fee $ ~' Date of Payment Receipt Number ~ Waiver Fee $ Oate of Payment Receipt Number 72.02S (Rev. N~V-OZ-gg I;:35 FRO~CTE ENVIRON~NTAL 56153~1 T-561 P.~Z/03 F-366 CT&£ Rrr. t/ Matrix Or~r~ B~ 99596400! Sc~TT Meier'an-, PE 4143 E 671h ,Ave 4143 E Drinl~al~ Water · ~mple Rermaks: Client ~ Coll~c~! Datrt'l'ime 10/25/99 16;45 g_~eivt, xl I~tdTime 10/25/99 16:'~6 T~lmlcal Ira-mot:. Stephen C. F. de AL&O~DLe Prep AnaLySis aiTrate-k 0.511 0,500 n~IIL EPA TOTAL Eotiform ¶ DB/IODNL, No CoLi SH18 g222B t0a~ 10/25199 1012519950. MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D, # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot £0~ B~ock Si C~pbe~ H~ight~ Location (address or directions) 4143 East 67th Av~ (b) Property owner Mailing Address 1)o~d ~ C~h~ Thom~6 Telephone:(home) 344-5709 Business 4145 Ea6.t. 67th Aucruz~_ Anchor~zg~., A~a6k~z 99507 (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Address ERA REALTY ATTN; David S~.~.J. uan Telephone (e) Mail the HAA to the following address: (or check here,l~ if hold for pick up.) List contact person and day phone number below: S & $ ENGINEERING 17034 Eagle River Loop KOad NO_, .~g~, Eagle River, Alaska ~57Z. 2. TYPE OF RESIDENCE Single-Family [~c Number of bedrooms 3. WATER SUPPLY Individual Well ~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site [] Public (~x. Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Re~.7/88) Page I of 2 Address Date 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Telephone ~ ~{~--~"~'~ ..~ - -~-te River Loop R~d No. =04 Eagle River, Ll==ka 6. DHHS APPROVAL .- Approved for -'~ bedrooms by Approved ,/./~ Disapproved Conditional Terms of Conditional Approval The Municipality of Anchorage Department of H~alth and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 · .,xO'~'_~,~ ~ MUNICIPALITY OF ANCHORAGE (MOA) ~' · ~'~'~ ~,50' Health Authority Approval (HAA) ~,O~~O CHECKLIST - FEBRUARY 1984 ,.~ ~,~, .%~ ~ 343-4744 A. WELL B~,'~,'%'~"' ' ' :' ' Well Classification~%~"' "~---,,/b L u ,'C3 ~ If A, B, C, D.E.C. Approved (y/N). Well Log Present (Y/~ ~'~ Date Completed "~V--- Yield '~,f~ Total Depth'~"~ 4-- ' i-~- ' _ Cased to ~ Depth of Grouting ('~ ! - t o ' ~1 ~."~ Static Water Level '~'7-.-~ Casing Height Above Ground ~,'7-.-~tw' Electrical Wiring in Conduit ~FN) H SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot ~ ~ I~ To Nearest Ed!~e of Abso'rptio~ Field on LOt ' Pump Set At "~ ~'1 ~ Sanitary Seal on Casing (~N) Depression Around Wellhead (~D ; On Adjoining Lots ~ ; On Adjoining Lots ' To Nearest Public Sewer Line "/'~ t"' To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot ~-~' ~''' B. SEPTIC/HOLDING TANK DATA ~lled : Size No. of Compartments Standpi~ Air-tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank~"~Y'H~l).._ Date Last Pumped __ ._ ' Holding-Tank High-Water Alarm (Y/N)' ~~..~~rmit (Y/N) SEPARATION DISTANCES FROM SEPTIC/H~ .To Water-Supply Well ' _ ~ To Building Foun~n To Property Line ~ To Disposal Field. ~ ' ToW e . Tt~t~m, Pond, Lake Or Malor Drainage Course 72'026 (Rev. Z/88) FrO~lt Page I of 2 C. ABSORPTION FIELD DATA ',' Soils Rating in Absorption Strata Width of Square Feet Depressio,~ over Field Results of Las! Adequac~ Type of System Design Length of Field SEPARATION DISTANCE FROM AB~ To Water-Supply Well - To Building Foundation = ' Lot _ To Water Mair Comments Depth of Field Gravel Bed Thickness Statndpipe~ ',Y/N) t Test LD: Property Line ) Existing or Abandoned System on ; On Adjoining Lo'ts , Lake, or Major Drainage Course .... ' Area, or Vehicle Storage Area D. LIFT STATION Sizel'~t"c~=a~ons . _ ~ _ ~ '_ ~: _ _. Manhole/Access (Y/N) '-'"'"'--' ' "Pump On"~ ~ ' "~ "Pu[m:pOff" Level_~t..----''''~ High Water Alarm Level at ~ __ ~ __ _ Tested for ~ Pumping Cycles during Adequacy Test, Meets MOA Electrical Codes (Y/~.N,L-~'''''~ -~ Comments inspection.__ o ,.~GINE£~.~IG..._ :- Signed , ~,n'~ r~,nle R~ve~:;I J:[.~c[No. 204 Company Eagle R,ver, AI~, MOANo. ' c- · **Check Permitted Bedroom Rating Against HAA Request~* I certify that I have checked, verified, or conformed to all MOA and HAA guide.!!r~es in effect on the date 'of this ~.~.,~ ~,. -':' ~ E n g i n.e ~ ~Seal/ -'. Recei~pt Waiver Fee: $ Date of Payment Page 2 of 2 Receipt No. , ~,~, -- ,~.:3 5/~_,-(~90 ' , Date of Payment ~/'-/'~' ~ ~' C) Amount: $ /~). ~ CHEMICAL & GEOLOGICAL LABORAT.=ORIES OF ALASKA, INC. FEDERAL TAX I.D. #92-0040440 Ozdeze~ ~y : I. ~E~ Ar~lyels Complete~ :NOV 12 $0 Ee~ Repo~t~ to: .................................. ~ ...... 7 ............. ~ ............................. ~ ........................................... Speclel Chs~eb lee 1:904780 Lab Dmpl ID: I ~tslz: Allowable ~e~a~et el: ~eet e~ lesult }IIYRATE-N 0,13 ~/1 SPA 353.2 10 lemrke: EA~I,E COUI.ECTE9 EY ~eete Performed See Special Ir~tructlora Above UA-Onavalhble None Detected "See Sampi.e lem&rke A~ove ADAMS · CORTHELL* LEE CONSULTING ENGINEERS July S~ 1960 Culver Realty Company glO0 Spenard Road Anchorage~ Alaska ATTENTIONJ Mr. Paul Thomasson PROJECTI Percolation Tests - Block 3~ Campbell Heights Subdivision Gentlemen~ Transmitted herewith arc the results of tests conducted the subject site at locations shown on the attached sketch. The routine tests were performed by Arctic Alaska Testlng Laboratories In accordance with the method prescribed in the FHA publication "Minimum Property Standards". The soils encountered arc sho~n on sheets 2-5 attached, The test results Indicate that the high water table encountered by the property owner of Lot 20 Is not consistent at the same elevation throughout fha area because our holes were augered fo lower elevations than thc elevation of the water on Lot 20. The holes were augcred In a ditch running East and West on fha South side of the property. Thls cas done to take advantage of the depth already excavated (approximately 3 feet). The holes were augered an addltlonal +3 feet of depth. This depth was considered refusal by hand meThods and If greater depths ere requlred~ we suggest that a power auger would be more economical due to fha large boulders encountered, The percolation rate In all four test holes was ! inch per minute. Should you have questions regarding the test results~ please feel free to contact this office. Very truly yours~ ADAMS - CORTHELL - LEE SA/ma Encls.